What makes Category 2 vouchers different from other NED vouchers?
Category 2 vouchers enable non-elderly persons with disabilities to transition from nursing homes and other healthcare institutions into the community. Only persons currently living in institutions are eligible to apply for these vouchers.
What agencies could apply to receive funding for Category 2 vouchers?
Only Public Housing Agencies (PHAs) that currently administer a HCV program were eligible to apply in response to the Notice of Funding Availability (NOFA) for these vouchers. In addition to meeting the NOFA threshold requirements, PHAs applying for Category 2 vouchers needed to partner with a state Medicaid or health agency or the state Money Follows the Person (MFP) Demonstration agency. MFP is a CMS initiative to help individuals move from institutions to community settings.
What families are eligible to apply for NED Category 2 vouchers?
In order to be eligible to receive a Category 2 voucher, in addition to being eligible for the PHA’s regular HCV program and a non-elderly person with a disability, the family’s head, co-head or sole member must be:
- Transitioning from a nursing home or other healthcare institution, and
- Provided the services needed to live independently in the community.
What types of institutions qualify as a “nursing home or other healthcare institution”?
Nursing Home or other healthcare institutions can be intermediate care facilities and specialized institutions that care for the mentally retarded, developmentally disabled, or mentally ill, but exclude board and care facilities (e.g. adult homes, adult day care, adult congregate living).
Can PHAs restrict NED Category 2 vouchers to only families referred to them by their partnering agency?
No. In order to ensure that individuals with all types of covered disabilities are eligible to receive assistance under this program, the PHA cannot limit who can apply to just those persons referred or approved by the MFP or State Health agency. Other individuals could be placed on the waiting list if they can show, with confirmation by an independent agency or organization that routinely provides such services (this can be the MFP or partnering agency, but need not be), that the transitioning individual will be provided with all necessary services, including care/case management.
Do families have to be selected from the PHA’s waiting list, or can they be referred directly from the partnering agency without being placed on the waiting list?
Families must be selected from the PHA’s waiting list. The partnering agency may make referrals of eligible families to the PHA for placement on the waiting list, and the PHA will then select these families from the waiting list for voucher issuance. Because language in the NOFA established that vouchers awarded under the NOFA must only serve non-elderly disabled families transitioning from institutions, the PHA does not need to establish a preference in order to serve these families ahead of other families on the PHA’s waiting list.
What if the PHA’s waiting list is closed?
The PHA must reopen its waiting list in order to be able to accept referrals from its partnering agency. When opening the waiting list, PHAs must advertise in accordance with 24 CFR 982.206. PHAs must give public notice in a local newspaper of general circulation, and also by minority media and other suitable means. The notice must state where and when to apply and comply with HUD fair housing requirements. The public notice must also state any limitations on who may apply for available slots in the program. For example, the PHA could limit the reopening of the waiting list only to those who qualify for Category 2 vouchers.
When opening the waiting list, how should PHAs reach eligible individuals in institutions?
The PHA must ensure that individuals living in eligible institutions are aware when the PHA opens its waiting list by reaching out to social service agencies, nursing homes, intermediate care facilities and specialized institutions in the local service area. The partnering service agency can play a vital role in assisting the PHA in this outreach effort and making sure that eligible Category 2 populations are aware of the vouchers and are referred to the PHA’s waiting list. PHAs and partnering agencies should think creatively about how to reach populations in the facilities including the use of Twitter, Facebook, websites, newsletters, and on-site visits.
How should PHAs reach out to families currently on their waiting list who may be eligible for these vouchers?
When advertising the availability of these vouchers, the PHA should advise any eligible applicants who are currently on the PHA’s waiting list to contact the PHA. The PHA may also reach potentially eligible families on their waiting list by sending out letters to non-elderly disabled applicants on the PHA’s waiting list, public advertisements, or may request a list of persons currently residing in nursing homes or institutions that are transition-ready from the MFP/Partnering Resource Agency. The PHA would then compare this list with their current waiting list. Any transition-ready persons already on the PHA’s waiting list would then be served first. The PHA will then verify eligibility through the MFP/Partnering Service Agency, or other qualified agency that will confirm that necessary services will be provided.
What if a PHA has difficulty locating eligible applicants within their jurisdiction, or who are willing to live in their jurisdiction?
PHAs must accept applications from people living outside their jurisdictions or from people being referred from other Medicaid/MFP service agencies in their state. In addition, the PHA may allow the families to port their voucher to other PHAs within the first year of receiving the voucher. In some cases, the supportive services a person needs in order to live in the community might only be available in an area outside the PHA’s jurisdiction. Even if the PHA has a policy of not allowing portability for non-resident applicants within the first year, the PHA must consider granting an exception to the policy if doing so provides a reasonable accommodation for a person with disabilities. Another option the PHA has is to revise the policy in its PHA administrative plan on portability for non-resident applicants to allow for immediate portability. The PHA can specify that this exception to their general policy applies only to NED Category 2 families.
Do applicants for NED Category 2 vouchers need to provide PHAs with original birth certificates or Social Security Cards?
Many residents of nursing homes and institutions don’t have access to birth certificates, social security cards or other standard forms of identification which PHAs may require. As proof of age and/or social security number (SSN), PHAs may accept other forms of documentation including an original document issued by a federal, state or local government agency which contains the applicant’s name, date of birth and/or SSN. This could be a document issued by the Social Security Administration or the state Medicaid or MFP agency. If the PHA’s policies require documents which a NED Category 2 applicant is unable to provide, the PHA may accept alternative government-issued documentation as a reasonable accommodation for a person with disabilities.
Can a NED Category 2 voucher be used in special housing types, including assisted living facilities, group homes, congregate housing, and shared housing?
Yes. Persons with disabilities transitioning out of institutional settings may choose housing in the community that is in a group or shared environment or where some additional assistance for daily living is provided for them on site. Under HUD regulations, group homes and shared housing are considered special housing types and are not excluded as an eligible housing type in the HCV program. Assisted living facilities are also considered eligible housing under the normal HCV program rules, as long as the costs for meals and other supportive services are not included in the housing assistance payments (HAP) made by the PHA to the owner, and that the person does not need continual medical or nursing care. In general, a PHA is not required to permit families to use any of the special housing types and may limit the number of families using such housing. However, the PHA must permit the use of a special housing type if doing so provides a reasonable accommodation so that the program is readily accessible to and usable by a person with disabilities.
How should PHAs handle changes in transitioning persons’ Social Security Administration payments in calculating a NED Category 2 family’s total tenant payment (TTP)?
While people with disabilities are living in nursing homes or institutions, they receive a limited payment of Supplemental Security Income (SSI) from the Social Security Administration (SSA). The amount of the payment increases substantially once the person transitions into the community; however, the documentation to verify the new amount might not be available when the PHA initially calculates the family’s income and total tenant payment (TTP) amounts. If the family does not have the verifying documents from the SSA at the time the PHA is performing the initial examination and income/TTP amounts, the PHA would base the income and TTP calculations on the amount of SSI the transitioning person currently has documentation to show that they receive (the smaller amount), and when the documentation with the new payment amount is available, the PHA must perform an interim reexamination to recalculate the family’s TTP. If the documentation with the new payment amount is available at the time the PHA initially calculates the family’s income and TTP, the PHA would use the amount the family is anticipated to receive.
What if the transitioning person can only find a unit where the gross rent exceeds the applicable payment standard for the family, and as a result they are unable to meet the rent burden requirement?
Upon initial occupancy of a unit, HCV participants may not contribute more than 40% of their income towards rent. If the transitioning person’s initial income is very limited (for example, if the reduced SSI amount is used to calculate the person’s income), and this makes it difficult for the person to find a unit that meets his/her needs where the family share will not exceed 40 percent of adjusted monthly income, the family may request an exception payment standard as a reasonable accommodation. On a case-by-case basis, a PHA may approve a payment standard amount up to 110 percent of the published fair market rent (FMR). Higher payment standards must be requested by the family and subsequently approved, as necessary, by the PHA after a family with a disabled person or an individual person with disabilities locates a unit. The HUD Field Office can approve exception payment standards above 110 percent to 120 percent of the FMR. Headquarters must waive 24 CFR 982.505(d) to allow the PHA to approve any exception payment standards higher than 120 percent of the FMR. Please reference Notice PIH 2011-19 (which extends Notice PIH 2010-11, Requests for Exception Payment Standards for Persons with Disabilities as a Reasonable Accommodation.